TY - JOUR
TI - Ticagrelor versus clopidogrel in patients with STEMI treated with thrombolysis: The MIRTOS trial
AU - Hamilos, M.
AU - Kanakakis, J.
AU - Anastasiou, I.
AU - Karvounis, C.
AU - Vasilikos, V.
AU - Goudevenos, J.
AU - Michalis, L.
AU - Koutouzis, M.
AU - Tsiafoutis, I.
AU - Raisakis, K.
AU - Stakos, D.
AU - Hahalis, G.
AU - Vardas, P.
JO - EuroIntervention
PY - 2021
VL - 16
TODO - 14
SP - 1163-1169
PB - Europa Group
SN - 1774-024X, 1969-6213
TODO - 10.4244/EIJ-D-20-00268
TODO - acetylsalicylic acid;  clopidogrel;  ticagrelor;  antithrombocytic agent;  clopidogrel;  ticagrelor, adult;  aged;  Article;  bleeding;  cardiovascular parameters;  clinical outcome;  controlled study;  coronary angiography;  corrected TIMI frame count;  female;  fibrinolytic therapy;  follow up;  human;  loading drug dose;  maintenance drug dose;  major adverse cardiac event;  major clinical study;  male;  middle aged;  multicenter study;  percutaneous coronary intervention;  radiological parameters;  randomized controlled trial;  ST segment elevation myocardial infarction;  clinical trial;  fibrinolysis;  fibrinolytic therapy;  percutaneous coronary intervention;  treatment outcome, Aged;  Clopidogrel;  Fibrinolysis;  Humans;  Percutaneous Coronary Intervention;  Platelet Aggregation Inhibitors;  ST Elevation Myocardial Infarction;  Thrombolytic Therapy;  Ticagrelor;  Treatment Outcome
TODO - Aims: We aimed to demonstrate whether coronary microvascular function is improved after ticagrelor administration compared to clopidogrel administration in STEMI subjects undergoing thrombolysis. Methods and results: MIRTOS is a multicentre study of ticagrelor versus clopidogrel in STEMI subjects treated with fibrinolysis. We enrolled 335 patients <75 years old with STEMI eligible for thrombolysis, of whom 167 were randomised to receive clopidogrel and 168 to receive ticagrelor together with thrombolysis. Primary outcome was the difference in post-PCI corrected TIMI frame count (CTFC). All clinical events were recorded in a three-month follow-up period. From the 335 patients who were randomised, 259 underwent PCI (129 clopidogrel and 130 ticagrelor) and 154 angiographies were analysable for the study primary endpoint. No significant difference was found between the clopidogrel (n=85) and ticagrelor (n=69) groups for CTFC (24.33±17.35 vs 28.33±17.59, p=0.10). No significant differences were observed in MACE and major bleeding events between randomisation groups (OR 2.0, 95% CI: 0.18-22.2, p=0.99). Conclusions: Thrombolysis with ticagrelor in patients <75 years old was not able to demonstrate superiority compared to clopidogrel in terms of microvascular injury, while there was no difference between the two groups in MACE and major bleeding events. Trial Registration. ClinicalTrials.gov Identifier: NCT02429271. EudraCT Number 2014-004082-25. © Europa Digital & Publishing 2021. All rights reserved.
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